Evidence review for intravenous fluid management strategy: Perioperative care in adults

National Guideline Centre (UK)

London: National Institute for Health and Care Excellence (UK); 2020 Aug.

Excerpt

The type of fluid administered in the perioperative period can have a significant effect on outcomes in patients have major surgery. There has been considerable debate over the safety and efficacy of crystalloids versus colloids. The key difference between crystalloids and colloids is that the colloids contain much larger molecules than that of crystalloids. Crystalloids are aqueous solutions of salts, minerals or any other water-soluble substances, for example, saline. Colloid solutions include hetastarch, dextran and plasma protein solutions. Since they are remaining in the vascular system, colloids are much more effective to use for expanding the circulatory volume than crystalloids. However, excessive use of colloids has been associated with side effects such as peripheral and pulmonary oedema and cardiac failure.

Recent evidence has been identified to address the question on the clinical and cost effectiveness of crystalloids versus colloids. The aim of this review is to perform a systematic review collating all of the relevant evidence.